Best time to take Zytiga

[Dastardly]

I have just started on Zytiga (500mg) and Prednisolone (5mg) and have been recommended to take Zytiga soon after I get up in the morning and then wait the required time before taking the Prednisolone with breakfast. Trouble is, I don't normally eat breakfast and am having to eat an extra snack I would rather not have as I am concerned about weight gain. I just wondered if anybody takes Zytiga at a different time of day and how that works.

[Magnus1964]

I was on a trial with Zytiga and it was found that taking it "with" food improved its performance. I don't think it matters what time of day you take it.

[Shams_Vjean in reply to Magnus1964]

Were you taking 1000mg with food, Magnus?

[Magnus1964 in reply to Shams_Vjean]

yes.

[dhccpa in reply to Magnus1964]

Wow. That must be quite effective. Can you tell us the trial details? Thanks.

[Magnus1964 in reply to dhccpa]

The trial was the first step to get approval from the FDA to allow Zytiga to be administered before chemo. The dosage was standard with the low dose prednisone. The first part of the trial had us taking Zytiga on an empty stomach. Then in mid trial the we were to switch to taking it with meals. My PSA took a further nose dive when I started to take it with food.

[dhccpa in reply to Magnus1964]

Thanks

[Doggedness in reply to Magnus1964]

I am pretty sure it definitely matters whether you take Zytiga with food or not because the dosage will need to be drastically different in each case.

[Scout4answers]

I take it at night Usually around midnight, or first time I get up to pee. I take the prednisone in the morning.

Has worked well for 5 months.

[Vangogh1961 in reply to Scout4answers]

I put it on the counter and take it when I get up in the night. Then no worries to have breakfast with the prednisone.

[GoBucks]

I take it when I get up to pee. Sometimes I am lucky and sleep late and just take it when I get up. I am not sure you need a full meal to take prednisone. Have a banana. Ask your Doc to be safe. Why are you only taking 500mg Zytiga?

[Dastardly in reply to GoBucks]

Doh. They are 500mg tablets, and I take 2, so I am taking 1000mg. I must report this new and unknown side effect that makes you stupid. Or, to be really factual, more stupid than normal

[j-o-h-n in reply to Dastardly]

Come on now DASTARDLY DO RIGHT.....You're not stupid you've got Pca.......

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 03/27/2022 10:38 PM DST

[Alice85 in reply to Dastardly]

Please no name calling.No question, answer, or knowledge is stupid.

[Dastardly in reply to Alice85]

Alice, I hope you didn't think j-o-h-n called me stupid, because he didn't. I called myself stupid for overlooking the blindingly obvious, and he was telling me not to be so hard on myself. I hope I've cleared this up for you.

[Alice85 in reply to Dastardly]

Thank you for clearing that up. You are not stupid. Your sensitivity comes out for your love for John.I am a sensitive MAN with Team sensitivity training.

My code name is from my loving kitty, Alice. This is a critical time for all of us living with cancer.

I hope a pray we all come away healthy.

It's especially tough on our loved ones.

Keep strong.

[TylexGP]

Hi There,

I am not necessarily recommending this but it is how I take my Zytiga. 1000mg when I get up. Do my morning chores which takes about 45 minutes run down to the local coffee shop to pick an iced coffee with cream. By that time it’s been an hour since taking my Zytiga and I take my pred and other non pca drugs. That’s my breakfast. So far it has worked well T less than 1 for almost a year.

[Dastardly in reply to TylexGP]

Yeah, it's all about routine isn't it? I guess the best answer is whatever works for you

[Tall_Allen]

The normal prescribed dose of Zytiga is 1000mg. It should be taken on an empty stomach (2 hrs since last meal) and wait an hour before eating. Prednisone may be nauseating if you take it without a meal. It is taken early in the day to mimic your normal cortisol patterns. If you take it too late, you will have a hard time sleeping.

[ukulele_grandpa in reply to Tall_Allen]

I take my second Prednisone (5mg) just before bed, with 3mg Melatonin. Generally sleep well until 2 to 4 am.

[Tall_Allen in reply to ukulele_grandpa]

Try taking it before noon to better simulate the natural cortisol pattern.

[CAMPSOUPS]

TA's response sums it up.

My routine: The effect of prednisone isn't hard on my stomach so I take it with my Zytiga.

Whether I plan on waking up or not one of my nighttime pee's is between 6 a.m. and 8 a.m. I take my Zytiga and prednisone at that time and either go back to sleep or get up.

Coffee is the first order of the day and I'm not starving when I get out of bed so and hour easily goes by after my dose of Zytiga/pred.

[StePeteMN]

Like others here, when on Zytiga I took it during the night and that worked well for me. Prednisone after breakfast. The huge Zytiga dosage as I understand was to make bioavailabilty more consistent across patients in the original trials. Taking 1000mg on an empty stomach means you're peeing away an awful lot of that spendy drug. You need enough of it, and enough is enough. Some doctors advise cutting dose in half, to reduce side effects, after it proves effective.

[CAMPSOUPS in reply to StePeteMN]

One more dosage trial would be nice to get clarity on the dosage. I have fantasized about it lol.

Reduced dosage on empty stomach.

Reduced dosage with food containing X percentage of fat.

I can't gamble so its full dose on empty stomach for me.

[GoBucks in reply to CAMPSOUPS]

Due to liver issues I had my dose reduced to 750 mg. Almost 4 years now. Still <0.01.

[Si52]

I started on 1000mg Zytiga with 10 mg of Pred. PSA dropped from 78 to 0.1 in about 4 months. I then reduced the dosage to 500 mg a day for about 6 months and then to 250 mg a day with low fat yoghurt. Then they stopped making 250mg pills. So I now take 500mg every alternate day with 5 mg Pred daily. PSA has remained below 0.015 for the last 2 years. Also doing quarterly Zoladex and Xgeva injections. Was diagnosed Gleason 9 with several bone metastases 3 years ago. Scans have been clear for the last 2 over years

[katartizo61 in reply to Si52]

That is so very good to read this morning, thank you Si52 for your post. 10 months for me and hoping he will adjust my dosage at some point down

[Si52 in reply to katartizo61]

You are most welcome, Sir. Unfortunately, with due respect, the typical oncologist will just follow what is printed. So, sometimes it's up to us to tell him/her that you would want to give dosage reduction a try. All the very best on our long journey

[dhccpa in reply to Si52]

My search reveals that at least generic abiraterone acetate is available in 250 mg. Is this something brand new?

[Si52 in reply to dhccpa]

As far as I know, the original Zytiga is only available in 500mg dosage

[dhccpa in reply to Si52]

Thanks, didn't know that, I'm not on it, but I've been pricing the generic.

[Scout4answers in reply to Si52]

I am taking a generic Abiraterone 4x 250 mg

[ukulele_grandpa in reply to Si52]

I'm on 250mg Abiraterone, the generic for Zytiga. in California USA. I'm 86 years old, had rad.prost. 17 years ago. Hip pain brought me in for CT, etc. when prostate cancer was found to have returned with a 6cm tumor inside the bone behind the socket. Stage 4 they tell me, because those pesky cells are likely all over my body. Took 5 radiation treatments two months ago and started Zytiga. Tumor has shrunk slightly psa dropped from 15 to 0.4, no pain medication necessary. I can walk without limping if I try.

[ukulele_grandpa in reply to ukulele_grandpa]

Is there a way to edit our entries? I meant four 250mg pills every morning.

[Bronzee in reply to Si52]

Weget generic Zytiga 500 from India. Three months supply for $515 including shipping.

[GoBucks in reply to Si52]

I take 3 250mg pills daily. Abiraterone acetate.

[Chrisbaird]

Started on 1000gms tablets dec 20 with 5gm prednisone with food Taking it once wake 1 hour before food was working well for me but after 4 months I was getting liver toxicity so has a break of a month then down to 500gm daily Dr put it down to other tablets I was taking for pulmonary fibrosis blood pressure to strong acidity PSA has been fine on 500gm for past 10 months

[Bronzee]

Hi, my husband is exactly on the same meds as you. Zytiga 2x500 upon waking up and 5 mg prednisone after eating breakfast. He is also given injections every 6 months of Pamorelin and xgeva every 3 months. He was diagnosed 2013 July Gleason 4+3 and was cancer free after RP for 8 years. No Chemo no radiation

PSA went up to 259 last Sept 2021 indicating a recurrence and mets to the iliac and 1 lymph node . He has no pain and no severe side effects except loss of muscle mass.

His PSA is now .198 after the injections and zytiga.

He is being monitored every 3 months

[ukulele_grandpa in reply to Bronzee]

The loss of muscle mass is a concern. I have a series of exercises I do 6 days a week...wall weights, a stationary Pogo stick, standing back exercises. It seems to help. I swam laps 3 mornings a week and walked 3 mornings before Covid, but they shut down the county pool and with my hip tumor I just walk a little.

[michael00]

I take it around 11 at night. And prednisone in the morning. It has worked well for me, close to 4 years now

[dougnola]

Hi Dastardly, I take it in the middle of the night when I pee. I put the nightly dosage in a pill box rather than straight from the bottle -since I’m groggy at night, it ensures you’ve taken your dose the next morning. I don’t think you need to wait exactly one hour for your prednisone w meal. It’s more to wait at least one hour. I’ve been taking it for 5 years and haven’t missed a dose with my trusty pill box! ✌️ DougNOLA

[katartizo61 in reply to dougnola]

are you on 5 mg Preg twice a day of do you take 10 mg once a day

[dougnola in reply to katartizo61]

I’m on 5mg once per day. I take it with my morning cereal/banana in work weekdays and with my late breakfast/brunch on weekends.

[katartizo61 in reply to dougnola]

5 mg one time a day, bonus!!! I have been wanting to try that due to sleep problems. Maybe without my MO's approval, might simply do that

[Hidden in reply to dougnola]

That's exactly my routine, except I also take Synthroid, which has to be on empty stomach at least 30 minutes before food. So I usually wake up to pee in my bedside bottle around 2:00 am and take Synthroid. Then next time I pee (between 3 and 5 am) I take my Zytiga. So I'm ready for that glorious coffee as soon as I get up, and Prednisone with breakfast! ☕😄

Finding a routine with Synthroid and Zytiga restrictions was like a Chinese puzzle.

[CAMPSOUPS in reply to dougnola]

Kind of same. I put my dose in a empty Altoids tin.

[Duk26]

My husband just started Zytiga/Prednisone this week. I read you can also take the Prednisone with a glass of milk vs food. Maybe that will help keep your calories down.

[leo2634]

I take it around 4:00 or 5:00 am depending on what time I get up to pee. I take it with a generous glass of water and the Prendisone with Breakfast. You said you don't eat breakfast if so maybe just a banana or a few crackers. The Prendisone can be a little harsh so eat something with it. I see you don't want the weights gain very noble approach but my Brother its coming. Stay active and hopefully enjoy many more years. I've been on Zytiga for over four years now and My PSA has been 0.1 since the start. If weight gain is your only side effects count your blessings. Never give up Never surrender. Leo

[db36867]

I take prednisone twice a day (once in the morning and once at night). If I do not take it with breakfast I make sure to eat a few crackers just to put something in my stomach. If not I feel nauseated. I was taking 1000mg of Zytiga but had liver problems so decreased to 700mg and no complications. I take it right before going to bed (at least 2 hours after my last meal).

[GoBucks in reply to db36867]

Nice to find someone else on reduced dose. Almost 4 years for me.

[BaliDream]

I take Zytiga at 9 in the morning, not with food…eat 1 hr before, or 2 hrs. after taking…take Prednisone at 6pm with food….

[Texan423]

Prednisone 5mg with 2 of my meals , usually breakfast and supper, Zytiga 1000 mg in between on an empty stomach usually 2hrs after breakfast and an hour before small midday meal. No side effects and good results +2 years now

[onajourney]

I have ritualized my medication taking. In the morning I take 1000mg of Abiraterone (Zytiga) any time after 5AM. I have it premeasured in a pill box kept in the bathroom so I don't have to identify pills or count in the early morning. Then I go back to bed.

When I get up for the day, usually 6:45 or later, I am ready for the first of my 5mg prednisone tabs. I make my wife and I lattes, then take that prednisone along with my other morning meds and eat a biscotti.

At 4PM my phone alarm goes off and I have my second 5mg prednisone. I usually pair it with a piece of dark chocolate and occasionally have an espresso too. (Sometimes I have a craft beer!)

This has been my routine since late 2018 and it has been working for me.

Best wishes as you find what works well for you.

[CocoTheAlphaCat in reply to onajourney]

Zytiga first thing in the morning; Prednisone with my first meal, which with intermittent fasting usually means early lunch. Whatever works, works.

[Dastardly in reply to CocoTheAlphaCat]

This sounds more like my sort of thing. I'll give it a go. Thanks

[21cakes]

I've been on it for about 9 month now. 10pm, no food 2hrs or more before, with prednisone and some other drugs, PSA over 1000 at start, dropped it to 12, started doubling every 6 weeks, then leveled off at 74 last 3 months. No adverse effects, slow steady improvement in blood composition, likewise for strength and endurance in daily workouts. PET scan this week showed resolution of some of the bone scan hot spots since the last one April 2021. Best of luck to you.

[garyjp9]

Like CampSoups, I take the prednisone and zytiga together on an empty stomach.

[NRH_Beach]

I try to take Zytiga when/if I get up to pee at 4/5/6am. I was also no breakfast for 30 years. I have added a non-fat yogurt+ fruit smoothy in the bullet blender.

[Flash64]

I take my Zytiga right before bed, so no evening snacking for me. I take the Prednisone in the morning just before breakfast.

[Lieto55]

Hi Dastardly - the key is to take Zytiga on a empty stomach as it's fat-soluble and a meal will amplify its impact at an unpredictable level, always much higher than fasting. The prednisone can be taken any time that day. It doesn't need to be as soon as possible. I share your eating pattern for the same reasons. So Zytiga whenever I wake up with a good slug of water ( a reason I don't take it late at night is purely that I don't want to try to sleep on a loaded bladder). Whenever I "break fast", usually 11-noon, I take the prednisone. It's not critical when, but food helps keep it from irritating the stomach. You blow the intermittent fast and all its benefits if you snack for the prednisone, so don't. Just take whenever you do eat.

[Dastardly in reply to Lieto55]

Thanks for your info. Much appreciated

[j-o-h-n]

It's fine as long as you're drinking with a straw..........

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 03/27/2022 10:40 PM DST

[Parscore]

I take my 500 Zytiga with food in the morning and the 5mg Prednisone at the same time. Hard to find a consensus even from Oncologist, if you go outside the guidelines of the clinical trials?

[Bspouse]

Hi - My husband has an extra pill - Prilosec - that he needs to take before the prednisolone. So he usually takes that at night. Then prednisolone with breakfast and ABI 2 hours later. Works unless there is a doctor appt in the morning. They originally prescribed protonix but that didnt agree with him so switched to prilosec. Possibly this isl due to stomach issues he had in the fall because no one else mentions it. Is he the only one taking prilosec to protect his stomach from the steroids?

[ukulele_grandpa]

Hi, For two months I've been taking Zytiga 1000mg and Prednisone 5mg together in the morning an hour to hour and a half before breakfast, then another Prednisone in the evening. My psa has dropped from 15 to 0.4 so far. I'm 6' tall and weigh 205 pounds, trying not to gain any. Seems like my belt size is increasing. Hmmm. I'm in California, USA If I were going to skip a meal every day it would be dinner, not breakfast.

[Alice85]

My doctor prescribed taking 4 tablets daily on an empty stomach, wait one hour then breakfast-No orange juice or grapefruit.Then I can take Prednisone about an hour later and another at dinner.

5weeks ago it was one Zytiga tablet, which did not stop the cancer growth in my lungs. But my PSA was still low. Another blood test and CT scan in two weeks.